Development and Validation of a Postprocedural Model to Predict Outcome After Endovascular Treatment for Ischemic Stroke
Authors: Vicky Chalos, Esmee Venema, Maxim J. H. L. Mulder, Bob Roozenbeek, Ewout W. Steyerberg, Marieke J. H. Wermer, Geert J. Lycklama à Nijeholt, H. Bart van der Worp, Mayank Goyal, Bruce C. V. Campbell, Keith W. Muir, Francis Guillemin, Serge Bracard, Philip White, Antoni Dávalos, Tudor G. Jovin, Michael D. Hill, Peter J. Mitchell, Andrew M. Demchuk, Jeffrey L. Saver, Aad van der Lugt, Scott Brown, Diederik W. J. Dippel, Hester F. Lingsma, Olvert A. Berkhemer, Puck S.S. Fransen, Debbie Beumer, Lucie A. van den Berg, Hester F. Lingsma, Albert J. Yoo, Wouter J. Schonewille, Jan Albert Vos, Paul J. Nederkoorn, Marieke J.H. Wermer, Marianne A.A. van Walderveen, Julie Staals, Jeannette Hofmeijer, Jacques A. van Oostayen, Geert J. Lycklama à Nijeholt, Jelis Boiten, Patrick A. Brouwer, Bart J. Emmer, Sebastiaan F. de Bruijn, Lukas C. van Dijk, L. Jaap Kappelle, Rob H. Lo, Ewoud J. van Dijk, Joost de Vries, Paul L.M. de Kort, Willem Jan. J. van Rooij, Jan S.P. van den Berg, Boudewijn A.A.M. van Hasselt, Leo A.M. Aerden, René J. Dallinga, Marieke C. Visser, Joseph C.J. Bot, Patrick C. Vroomen, Omid Eshghi, Tobien H.C.M.L. Schreuder, Roel J.J. Heijboer, Koos Keizer, Alexander V. Tielbeek, Heleen M. den Hertog, Dick G. Gerrits, Renske M. van den Berg-Vos, Giorgos B. Karas, Ewout W. Steyerberg, H. Zwenneke Flach, Henk A. Marquering, Marieke E.S. Sprengers, Sjoerd F.M. Jenniskens, Ludo F.M. Beenen, René van den Berg, Peter J. Koudstaal, Wim H. van Zwam, Yvo B.W.E.M. Roos, Aad van der Lugt, Robert J. van Oostenbrugge, Charles B.L.M. Majoie, Diederik W.J. Dippel, Martin M. Brown, Thomas Liebig, Theo Stijnen, Tommy Andersson, Heinrich Mattle, Nils Wahlgren, Esther van der Heijden, Naziha Ghannouti, Nadine Fleitour, Imke Hooijenga, Corina Puppels, Wilma Pellikaan, Annet Geerling, Annemieke Lindl-Velema, Gina van Vemde, Ans de Ridder, Paut Greebe, Tiny Simons, Gert Messchendorp, Friedus van der Minne, Nicole Aaldering, Marjan Elfrink, José de Bont-Stikkelbroeck, Joke de Meris, Kirsten Janssen, Willy Struijk, Hester Bongenaar, Karin Bodde, Silvan Licher, Nikki Boodt, Adriaan Ros, Esmee Venema, Ilse Slokkers, Raymie-Jayce Ganpat, Maxim Mulder, Nawid Saiedie, Alis Hesmatollah, Stefanie Schipperen, Stefan Vinken, Tiemen van Boxel, Jeroen Koets, Merel Broers, Emilie Santos, Jordi Borst, Ivo Jansen, Manon Kappelhof, Marit Lucas, Ralph Geuskens, Renan Sales Barros, Roeland Dobbe, Marloes Csizmadia, M.D. Hill, Mayank Goyal, Andrew M. Demchuk, Bijoy K. Menon, M. Eesa, K.J. Ryckborst, M.R. Wright, N.R. Kamal, L. Andersen, P.A. Randhawa, T. Stewart, S. Patil, P. Minhas, Mohammed A. Almekhlafi, S. Mishra, F. Clement, T. Sajobi, A. Shuaib, W.J. Montanera, D. Roy, F.L. Silver, T.G. Jovin, D.F. Frei, B. Sapkota, J.L. Rempel, J. Thornton, D. Williams, D. Tampieri, A.Y. Poppe, D. Dowlatshahi, J.H. Wong, A.P. Mitha, S. Subramaniam, M.W. Lowerison, M. Salluzzi, M. Maxwell, S. Lacusta, E. Drupals, K. Armitage, P.A. Barber, E.E. Smith, W.F. Morrish, S.B. Coutts, C. Derdeyn, B. Demaerschalk, D. Yavagal, R. Martin, R. Brant, Y. Yu, R.A. Willinsky, A. Weill, C. Kenney, H. Aram, P.K. Stys, T.W. Watson, G. Klein, D. Pearson, P. Couillard, A. Trivedi, D. Singh, E. Klourfeld, O. Imoukhuede, D. Nikneshan, S. Blayney, R. Reddy, P. Choi, M. Horton, T. Musuka, V. Dubuc, T.S. Field, J. Desai, S. Adatia, A. Alseraya, V. Nambiar, R. van Dijk, N.J. Newcommon, B. Schwindt, K. Butcher, T. Jeerakathil, B. Buck, K. Khan, S.S. Naik, D.J. Emery, R.J. Owen, T.B. Kotylak, R.A. Ashforth, T.A. Yeo, D. McNally, M. Siddiqui, M. Saqqur, D. Hussain, H. Kalashyan, A. Manosalva, M. Kate, L. Gioia, S. Hasan, A. Mohammad, M. Muratoglu, A. Cullen, P. Brennan, A. O Hare, S. Looby, D. Hyland, S. Duff, M. Mc Cusker, B. Hallinan, S. Lee, J. Mc Cormack, A. Moore, M. O'Connor, C. Donegan, L. Brewer, A. Martin, S. Murphy, K. O'Rourke, S. Smyth, P. Kelly, T. Lynch, T. Daly, P. O'Brien, A. O'Driscoll, M. Martin, R. Collins, T. Coughlan, D. McCabe, D. O'Neill, M. Mulroy, O. Lynch, T. Walsh, M. O'Donnell, T. Galvin, J. Harbison, P. McElwaine, K. Mulpeter, C. McLoughlin, M. Raerdon, E. Harkin, E. Dolan, M. Watts, N. Cunningham, C. Fallon, S. Gallagher, P. Cotter, M. Crowe, R. Doyle, I. Noone, M. Lapierre, V.A. Coté, S. Lanthier, C. Odier, A. Durocher, J. Raymond, N. Daneault, Y. Deschaintre, T. Jovin, B. Jankowitz, L. Baxendell, L. Massaro, C. Jackson-Graves, S. Decesare, P. Porter, K. Armbruster, A. Adams, J. Billigan, J. Oakley, A. Ducruet, A. Jadhav, D.V. Giurgiutiu, A. Aghaebrahim, V. Reddy, M. Hammer, M. Starr, V. Totoraitis, L. Wechsler, S. Streib, S. Rangaraju, D. Campbell, M. Rocha, D. Gulati, T. Krings, L. Kalman, A. Cayley, J. Williams, R. Wiegner, L.K. Casaubon, C. Jaigobin, J.M. del Campo, J.D. Schaafsma, R. Agid, R. Farb, K. ter Brugge, B.L. Sapkoda, B.W. Baxter, K. Barton, A. Knox, A. Porter, A. Sirelkhatim, T. Devlin, C. Dellinger, N. Pitiyanuvath, J. Patterson, J. Nichols, S. Quarfordt, J. Calvert, H. Hawk, C. Fanale, A. Bitner, A. Novak, D. Huddle, R. Bellon, D. Loy, J. Wagner, I. Chang, E. Lampe, B. Spencer, R. Pratt, R. Bartt, S. Shine, G. Dooley, T. Nguyen, M. Whaley, K. McCarthy, J. Teitelbaum, W. Poon, N. Campbell, M. Cortes, C. Lum, R. Shamloul, S. Robert, G. Stotts, M. Shamy, N. Steffenhagen, D. Blacquiere, M. Hogan, M. AlHazzaa, G. Basir, H. Lesiuk, D. Iancu, M. Santos, H. Choe, D.C. Weisman, K. Jonczak, A. Blue-Schaller, Q. Shah, L. MacKenzie, B. Klein, K. Kulandaivel, O. Kozak, D.J. Gzesh, L.J. Harris, J.S. Khoury, J. Mandzia, D. Pelz, S. Crann, L. Fleming, K. Hesser, B. Beauchamp, B. Amato-Marzialli, M. Boulton, P. Lopez-Ojeda, M. Sharma, S. Lownie, R. Chan, R. Swartz, P. Howard, D. Golob, D. Gladstone, K. Boyle, M. Boulos, J. Hopyan, V. Yang, L. Da Costa, C.A. Holmstedt, A.S. Turk, R. Navarro, E. Jauch, S. Ozark, R. Turner, S. Phillips, J. Shankar, J. Jarrett, G. Gubitz, W. Maloney, R. Vandorpe, M. Schmidt, J. Heidenreich, G. Hunter, M. Kelly, R. Whelan, L. Peeling, P.A. Burns, A. Hunter, I. Wiggam, E. Kerr, M. Watt, A. Fulton, P. Gordon, I, Rennie, P. Flynn, G. Smyth, S. O'Leary, N. Gentile, G. Linares, P. McNelis, K. Erkmen, P. Katz, A. Azizi, M. Weaver, C. Jungreis, S. Faro, P. Shah, H. Reimer, V. Kalugdan, G. Saposnik, A. Bharatha, Y. Li, P. Kostyrko, T. Marotta, W. Montanera, D. Sarma, D. Selchen, J. Spears, J.H. Heo, K. Jeong, D.J. Kim, B.M. Kim, Y.D. Kim, D. Song, K-J Lee, J. Yoo, O.Y. Bang, S. Rho, J. Lee, P. Jeon, K.H. Kim, J. Cha, S.J. Kim, S. Ryoo, M.J. Lee, S-I Sohn, C-H Kim, H-G Ryu, J-H Hong, H-W Chang, C-Y Lee, S.M. Davis, G.A. Donnan, B.C.V. Campbell, P.J. Mitchell, L. Churilov, B. Yan, R.J. Dowling, N. Yassi, T.J. Oxley, T.Y. Wu, G. Silver, A. McDonald, R. McCoy, T.J. Kleinig, R. Scroop, H.M. Dewey, M. Simpson, M. Brooks, B. Coulton, M. Krause, T.J. Harrington, B. Steinfort, K. Faulder, M. Priglinger, S. Day, T. Phan, W. Chong, M. Holt, R.V. Chandra, H. Ma, D. Young, K. Wong, T. Wijeratne, H. Tu, E. Mackay, D. Celestino, C.F. Bladin, P.S. Loh, A. Gilligan, Z. Ross, S. Coote, T. Frost, M.W. Parsons, F. Miteff, C.R. Levi, T. Ang, N. Spratt, L. Kaauwai, M. Badve, H. Rice, L. de Villiers, B. McGuinness, A. Hope, M. Moriarty, P. Bennett, Andrew Wong, Alan Coulthard, Andrew Lee, Jim Jannes, Deborah Field, G. Sharma, S. Salinas, E. Cowley, B. Snow, J. Kolbe, R. Stark, J. King, R. Macdonnel, J Attia, C. D'Este, Jeffrey A. Saver, Hans-Christoph Diener, Elad I. Levy, Alain Bonafé, Vitor M. Pereira, Reza Jahan, Gregory W. Albers, Christophe Cognard, David J. Cohen, Werner Hacke, Olav Jansen, Tudor G. Jovin, Heinrich P. Mattle, Raul G. Nogeira, Adnan H. Siddiqui, Dileep R. Yavagal, Rüdiger von Kummer, Wade Smith, Francis Turjman, Scott Hamilton, Richard Chiacchierini, Arun Amar, Nerses Sanossian, Yince Loh, Thomas G. Devlin, Blaise W. Baxter, Vivek K. Reddy, A. Horev, D-V. Giurgiutiu, V.K. Totoraitis, M. Star, L.N. Hopkins, K. Snyder, R. Sawyer, S. Hall, V. Costalat, C. Riquelme, P. Machi, E. Omer, C. Arquizan, I. Mourand, M. Charif, X. Ayrignac, N. Menjot de Champleur, N. Leboucq, G. Gascou, M. Moynier, Richard du Mesnil de Rochemont, Oliver Singer, J. Berkefeld, C. Foerch, M. Lorenz, W. Pfeilschifer, E. Hattingen, M. Wagner, S-J. You, S. Lescher, H. Braun, S. Dehkharghani, S.R. Belagaje, A. Anderson, A. Lima, M. Obideen, D. Haussen, R. Dharia, M. Frankel, V. Patel, K. Owada, A. Saad, L. Amerson, C. Horn, S. Doppelheuer, K. Schindler, Demetrius K. Lopes, M. Chen, R. Moftakhar, C. Anton, M. Smreczak, J.S. Carpenter, S. Boo, A. Rai, T. Roberts, A. Tarabishy, L. Gutmann, C. Brooks, J. Brick, J. Dominico, G. Reimann, K. Hinrichs, M. 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Sonnberger, K. Nussbaumer, C. Dominger, E. Bach, B.D. Jagadeesan, R. Taylor, J. Kim, K. Shea, R. Tummala, H. Zacharatos, D. Sandhu, M. Ezzeddine, A. Grande, D. Hildebrandt, K. Miller, J. Scherber, A. Hendrickson, M. Jumaa, S. Zaidi, T. Hendrickson, V. Snyder, M. Killer-Oberpfalzer, J. Mutzenbach, F. Weymayr, E. Broussalis, K. Stadler, A. Jedlitschka, A. Malek, N. Mueller-Kronast, P. Becker, C. Martin, D. Summers, J. Day, I. Bettinger, W. Holloway, K. Olds, S. Arkin, N. Akhtar, C. Boutwell, S. Crandall, M. Schwartzman, C. Weinstein, B. Brion, S. Prothmann, J. Kleine, K. Kreiser, T. Boeck-Behrens, H. Poppert, S. Wunderlich, M.L. Koch, V. Biberacher, A. Huberle, G. Gora-Stahlberg, B. Knier, T. Meindl, D. Utpadel-Fischler, M. Zech, M. Kowarik, C. Seifert, B. Schwaiger, A. Puri, S. Hou, A. Wakhloo, M. Moonis, N. Henniger, R. Goddeau, F. Massari, A. Minaeian, J.D. Lorazo, M. Ramzan, C. Stout, A. Patel, A. Tunguturi, S. Onteddu, R. Carandang, M. Howk, Antoni Dávalos, Angel Chamorro, Carlos A. Molina, Joaquin Serena, Luis San Román, Angeles de Miquel, Àlex Rovira, Erik Cobo, G. Albers, K. Lees, J. Arenillas Lara, R. Roberts, F. Al-Ajlan, M. Salluzi, L. Zimmel, S. Patel, R. von Kummer, J. Martí-Fàbregas, J. Serena, M. Salvat-Plana, E. López-Cancio, M. Hernandez-Pérez, M. Ribó, E. Sanjuan, M. Rubiera, J. Pagola, A. Flores, M. Muchada, P. Meler, E. Huerga, S. Galabert, P. Coscojuela, A. Tomasello, D. Rodriguez, E. Santamarina, O. Maisterra, S. Boned, L. Seró, M. Millán, L. Muñoz, N. Pérez de la Ossa, M. Gomis, L. Dorado, E. Palomeras, J. Munuera, P. García Bermejo, S. Remollo, C. Castaño, R. García-Sort, P. Cuadras, P. Puyalto, M. Jiménez, A. Martínez-Piñeiro, G. Lucente, X. Urra, V. Obach, A. Cervera, S. Amaro, L. Llull, J. Codas, M. Balasa, J. Navarro, N. Macías, P. Cardona, H. Quesada, F. Rubio, L. Cano, B. Lara, M.A. de Miquel, L. Aja, Serge Bracard, Xavier Ducrocq, Jean-Louis Mas, M. Soudant, Catherine Oppenheim, Thierry Moulin, Francis Guillemin, Xavier Leclerc, Serge Timsit, Mathieu Zuber, Didier Dormont, Luc Picard, Jean-Luc Novella, Nadine Petitpain, Sébastian Richard, Romain Bourcier, Sébastian Soize, Hélène Raoult, Marie Tisserand, Olivier Naggara, Fréderic Clarencon, Anne-Laure Derelle, René Axionnat, Pierre-Alexandre Baillot, Charlotte Barbier, Jean-Christophie Lacour, Nelly Agrinier, Serge Bakchine, Flore Baronnet-Chauvet, Marine Beaumont, Yannick Bejot, Jerôme Berge, Marc Bintner, Tae Hee Cho, Julien Cogez, Charlotte Cordonnier, Christian Denier, Olivier Detante, Anthony Faivre, Anne Ferrier, Laetitia Gimenez, Sophie Godard Ducceschi, Benoît Guillon, Emmanuel Houdart, Bertrand Lapergue, Raul Mariano Musacchio, Jean-Philippe Neau, Michaël Obadia, Anne Pasco-Papon, Michel Piotin, Laurent Pierot, Frederic Ricolfi, Thomas Ronziere, Guillaume Saliou, Igor Sibon, Jacques Sedat, Christian Stapf, Laurent Suissa, Stephane Velasco, Yves Samson, Nader Sourour, Sophie Crozier, Sandrine Deltour, Federico Di Maria, Raphael Le Bouc, Anne Leger, Gurkan Mutlu, Charlotte Rosso, Zoltan Szatmary, Marion Yger, Chiara Zavanone, Nathalie Caucheteux, Laurent Estrade, Krzysztof Kadziolka, Alexandre Leautaud, Céline Renkes, Isabelle Serre, Hubert Desal, Claire Boutoleau-Bretonniere, Benjamin Daumas-Duport, Solène De Gaalon, Pascal Derkinderen, Sarah Evain, Fanny Herisson, David-Axel Laplaud, Thibaud Lebouvier, Alina Lintia-Gaultier, Hélène Pouclet-Courtemanche, Tiphaine Rouaud, Violaine Rouaud Jaffrenou, Aurélia Schunck, Mathieu Sevin, Fredereque Toulgoat, Sandrine Wiertlewski, Jean-Yves Gauvrit, Vincent Cahagne, Jean-Christophie Ferre, Jean-François Pinel, Jean-François Meder, Amen-Adam Al Najjar-Carpentier, Julia Birchenall, Eric Bodiguel, David Calvet, Valérie Domigo, Sylvie Godon-Hardy, Vincent Guiraud, Catherine Lamy, Loubna Majhadi, Ludovic Morin, Denis Trystam, Guillaume Turc, Xavier Barreau, François Rouanet, Sabrina Debruxelles, Annabelle Kazadi, Pauline Renou, Olivier Fleury, Frédéric Dubas, Jildaz Caroff, Marie-Aurélie Hamon, Alderic Lecluse, Guillaume Marc, Maurice Giroud, Adrien Chavent, Arnaud Gentil, Apolline Kazemi, Guy-Victor Osseby, Charlotte Voguet, Marie-Hélène Mahagne, Yves Chau, Sylvain Lachaud, Frédérique Buffon Porcher, Hugues Chabriat, Pierre Guedin, Dominique Herve, Eric Jouvent, Jérôme Mawet, Jean-Pierre Saint-Maurice, Hans-Martin Schneble, Norbert Nighoghossian, Nadia-Nawel Berhoune, Françoise Bouhour, Laurent Derex, Hélène Gervais-Bernard, Benjarmin Gory, Luis Manera, Laura Mechtouff, Thomas Ritzenthaler, Roberto Riva, Fabrizio Salaris Silvio, Caroline Tilikete, Raphael Blanc, Marion Bruno Bartolini, Antoine Gueguen, Silvia Pistocchi, Hocine Redjem, Jacques Drouineau, Gaelle Godeneche, Matthias Lamy, Emilia Marsac, Pierre Clavelou, Emmanuel Chabert, Nathalie Bourgois, Catherine Cornut-Chauvinc, Jean Gabrillargues, Betty Jean, Anna-Raquel Marques, Nicolas Vitello, Marianne Barbieux, Kamel Boubagra, Isabelle F. Wiki, Katia Garambois, Florence Tahon, Vasdev Ashok, Oguzhan Coskun, Georges Rodesch, Frédéric Bourdain, Serge Evrard, Philippe Graveleau, Jean Pierre Decroix, Adrien Wang, François Sellal, Guido Ahle, Gabriela Carelli, Marie-Hélène Dugay, Claude Gaultier, Ariel P. Lebedeinsky, Lavinia Lita, Catherine Renglewicz-Destuynder, Alain Tournade, Françis Vuillemet, Francisco M. Montoro, Charbel Mounayer, Frederic Faugeras, Catherine Labach, Géraldine Lautrette, Olivier Chassin, Claire Dussaule, Elsa Melki, Augustin Ozanne, Francesco Puccinelli, Marina Sachet, Sarov Mariana, Jean-François Bonneville, Allessandra Biondi, Elisabeth De Bustos Medeiros, Fabrice Vuillier, Patrick Courtheoux, Fausto Viader, Marion Apoil-Brissard, Mathieu Bataille, Anne-Laure Bonnet, Emmanuel Touze, Didier Leys, Mohamed Aggour, Pierre Aguettaz, Marie Bodenant, Dominique Deplanque, Marie Girot, Hilde Henon, Erwah Kalsoum, Christian Lucas, Jean-Pierre Pruvo, Paolo Zuniga, Caroline Arquizan, Vincent Costalat, Paolo Machi, Isabelle Mourand, Carlos A. Riquelme, Pierre Bounolleau, Charles Arteaga, Patrice Tournebize, Cyril Charlin, Françoise Darcel, Pascale Gauthier-Lasalarie, Marcia Jeremenko, Servane Mouton, Jean-Baptiste Zerlauth, Chantal Lamy, Hervé Deramond, Hassan Hosseini, André Gaston, Francis-Guy Barral, Pierre Garnier, Rémy W.V. Beaujeux, Denis D.S. Herbreteau, Alicia Murray, Gary Ford, Keith Muir, Phil White, Martin M Brown, Andrew Clifton, Janet Freeman, Ian Ford, Hugh Markus, Joanna Wardlaw, Claudia-Martina Messow, Kennedy Lees, Andy Molyneux, Steff Lewis, Tom Robinson, John Norrie, Fergus Robertson, Richard Perry, Anand Dixit, Geoffrey C. Cloud, Jeremy Madigan, Christine Roffe, Sanjeev Nayak, Kyriakos Lobotesis, Craig Smith, Amit Herwadkar, Naga Kandasamy, Tony Goddard, John Bamford, Ganesh Subramanian, Rob Lenthall, Edward Littleton, Sal Lamin, Kelly Storey, Rita Ghatala, Azra Banaras, John Aeron-Thomas, Bath Hazel, Holly Maguire, Emelda Verqaue, Louise Harrison, Rekha Keshvara, James Cunningham, Wim van Zwam, Ivo G.H. Jansen, Maxim J.H.L. Mulder, Robert- Jan B. Goldhoorn, Kars C.J. Compagne, Josje Brouwer, Sanne J. den Hartog, Wouter H. Hinsenveld, Bob Roozenbeek, Adriaan C.G.M. van Es, Jonathan M. Coutinho, Jasper M. Martens, Sebastiaan F de Bruijn, H. Bart van der Worp, Hieronymus D. Boogaarts, J. de Vries, Julia van Tuijl, Jo P. Peluso, Puck Fransen, Maarten Uyttenboogaart, Omid Eschgi, Reinoud P.H. Bokkers, Lonneke S.F. Yo, Tomas Bulut, Paul J.A.M. Brouwers, Alida A. Postma, Stefan D. Roosendaal, Bas F.W. van der Kallen, Ido R. van den Wijngaard, Joost Bot, Pieter-Jan van Doormaal, Anton Meijer, Elyas Ghariq, Marc P. van Proosdij, G. Menno Krietemeijer, Wouter Dinkelaar, Auke P.A. Appelman, Bas Hammer, Sjoert Pegge, Anouk van der Hoorn, Saman Vinke, Naziha el Ghannouti, Martin Sterrenberg, Rita Sprengers, Michelle Simons, Marjolein Vossers, Tamara Vermeulen, Annet Geerlings, Nynke Nicolaij, Sandra Kleijn, Jasmijn Lodico, Hanneke Droste, Maureen Wollaert, Sabrina Verheesen, D. Jeurrissen, Erna Bos, Yvonne Drabbe, Michelle Sandiman, Nicoline Aaldering, Berber Zweeijk, Jocova Vervoort, Eva Ponjee, Sharon Romviel, Karin Kanselaar, Denn Barning, Vicky Chalos, Ralph R. Geuskens, Tim van Straaten, Saliha Ergezen, Roger R.M. Harmsma, Daan Muijres, Anouk de Jong, Anna M.M. Boers, J. Huguet, P.F.C. Groot, Marieke A. Mens, Katinka R. van Kranendonk, Kilian M. Treurniet, Manon L. Tolhuisen, Heitor Alves, Annick J. Weterings, Eleonora L.F. Kirkels, Eva J.H.F. Voogd, Lieve M. Schupp, Sabine L. Collette, Adrien E.D. Groot, Natalie E. LeCouffe, Praneeta R. Konduri, Haryadi Prasetya, Nerea Arrate-Terreros, Lucas A. Ramos
Journal: JAMA Neurology (2023)

Importance Outcome prediction after endovascular treatment (EVT) for ischemic stroke is important to patients, family members, and physicians. Objective To develop and validate a model based on preprocedural and postprocedural characteristics to predict functional outcome for individual patients after EVT. Design, Setting, and Participants A prediction model was developed using individual patient data from 7 randomized clinical trials, performed between December 2010 and December 2014. The model was developed within the Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials (HERMES) collaboration and external validation in data from the Dutch Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry of patients treated in clinical practice between March 2014 and November 2017. Participants included patients from multiple centers throughout different countries in Europe, North America, East Asia, and Oceania (derivation cohort), and multiple centers in the Netherlands (validation cohort). Included were adult patients with a history of ischemic stroke from an intracranial large vessel occlusion in the anterior circulation who underwent EVT within 12 hours of symptom onset or last seen well. Data were last analyzed in July 2022. Main Outcome(s) and Measure(s) A total of 19 variables were assessed by multivariable ordinal regression to predict functional outcome (modified Rankin Scale [mRS] score) 90 days after EVT. Variables were routinely available 1 day after EVT. Akaike information criterion (AIC) was used to optimize model fit vs model complexity. Probabilities for functional independence (mRS 0-2) and survival (mRS 0-5) were derived from the ordinal model. Model performance was expressed with discrimination (C statistic) and calibration. Results A total of 781 patients (median [IQR] age, 67 [57-76] years; 414 men [53%]) constituted the derivation cohort, and 3260 patients (median [IQR] age, 72 [61-80] years; 1684 men [52%]) composed the validation cohort. Nine variables were included in the model: age, baseline National Institutes of Health Stroke Scale (NIHSS) score, prestroke mRS score, history of diabetes, occlusion location, collateral score, reperfusion grade, NIHSS score at 24 hours, and symptomatic intracranial hemorrhage 24 hours after EVT. External validation in the MR CLEAN Registry showed excellent discriminative ability for functional independence (C statistic, 0.91; 95% CI, 0.90-0.92) and survival (0.89; 95% CI, 0.88-0.90). The proportion of functional independence in the MR CLEAN Registry was systematically higher than predicted by the model (41% vs 34%), whereas observed and predicted survival were similar (72% vs 75%). The model was updated and implemented for clinical use. Conclusion and relevance The prognostic tool MR PREDICTS@24H can be applied 1 day after EVT to accurately predict functional outcome for individual patients at 90 days and to provide reliable outcome expectations and personalize follow-up and rehabilitation plans. It will need further validation and updating for contemporary patients.